Preoperative exchange transfusion for sickle cell disease patients undergoing open-heart surgery: an exception to the rule.

Preoperative exchange transfusion is a routine practice in patients with sickle cell disease having elevated sickle cell hemoglobin levels (>40%) undergoing open-heart surgery on cardiopulmonary bypass. A new approach toward acceptance and management of sickle cell disease patients with high sickle cell hemoglobin levels for open-heart surgery without preoperative exchange transfusion of blood is presented.